Provider Demographics
NPI:1144570680
Name:JURKOVIC, SARAH J (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:J
Last Name:JURKOVIC
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6006 159TH ST
Mailing Address - Street 2:BUILDING C
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-2904
Mailing Address - Country:US
Mailing Address - Phone:708-535-7320
Mailing Address - Fax:
Practice Address - Street 1:6006 159TH ST
Practice Address - Street 2:BUILDING C
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-2904
Practice Address - Country:US
Practice Address - Phone:708-535-7320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042953A103TC0700X
IL071.009579103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical